Provider Demographics
NPI:1497301766
Name:ADVANCE HEALTHCARE SOLUTIONS
Entity Type:Organization
Organization Name:ADVANCE HEALTHCARE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIAMA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-891-9267
Mailing Address - Street 1:8036 ALLOWAY LN
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-6323
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4005 SEVEN MILE LN STE 1
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-6125
Practice Address - Country:US
Practice Address - Phone:301-891-9267
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-13
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD302058400Medicaid